Modelo de gestão de desempenho : o caso ACES Cova da Beira

Os Cuidados de Saúde Primários fazem parte integrante do sistema de saúde, assim como do desenvolvimento social e económico global da comunidade. Proporciona o primeiro nível de contacto do indivíduo, da família e da comunidade, permitindo a prestação de cuidados de saúde o mais perto possível dos locais onde a população vive e trabalha. Os cuidados de saúde constituem um aspeto fundamental do desenvolvimento económico e social de qualquer país, pelo que assumem uma atual relevância no nosso domínio sociopolítico. Por isso, partilhamos das preocupações dominantes, que nos dizem que há necessidade de fortalecer os cuidados de saúde primários e de diminuir a procura dos cuidados no hospital, de forma a satisfazer melhor e mais economicamente as necessidades dos cidadãos. Sendo o direito à saúde um direito fundamental de todos os seres humanos, a preocupação dos cuidados de saúde primários deverá privilegiar a promoção e educação para a saúde e a prevenção da doença. Assim, num serviço de saúde que pretende visar os indivíduos, as famílias e a própria comunidade, os cuidados a prestar ultrapassam a atividade desenvolvida dentro do Centro de Saúde. O projeto aplicado que se apresenta diz respeito a um trabalho de âmbito institucional e tem como objeto de estudo o Agrupamento de Centros de Saúde da Cova da Beira - ACeS Cova da Beira, que atua na área da prestação de cuidados de saúde primários. Procede-se à caraterização e diagnóstico do serviço e apresenta-se uma solução de gestão do desempenho organizacional, a partir da análise efetuada e assente na revisão da literatura constituída pela metodologia de sistema de gestão de desempenho baseado no Balanced Scorecard. Os resultados obtidos evidenciam a utilização do Balanced Scorecard como Instrumento de Gestão Estratégica do Desempenho adaptado ao Serviço de Saúde em estudo que, no caso de vir a ser implementado, vem proporcionar uma efetiva gestão do desempenho organizacional, com uma consequente utilização eficiente e eficaz dos recursos, de forma equilibrada e alinhada estrategicamente.Les Soins de Santé Primaires sont une partie intégrante du système de santé, ainsi que du développement social et économique global de la communauté. Ils facilitent le premier niveau de contact de l’individu, de la famille et de la communauté, en permettant la prestation de soins de santé tout proche des endroits où la population vit et travaille. Les soins de santé sont un élément fondamental du développement économique et social de tous les pays et assument donc un actuel et important intérêt dans notre domaine sociopolitique. Ainsi, nous partageons des préoccupations dominantes qui nous transmettent la nécessité de fortifier les soins de santé primaires et de baisse la recherche des soins dans l’hôpital, en satisfaisant meilleur et plus économiquement les besoins des citoyens. En étant le droit à la santé un droit fondamental de tous les êtres humains, la préoccupation des soins de santé primaires devra privilégier la promotion et éducation pour la santé et la prévention de la maladie. Ainsi, dans un service de santé qui aspire à viser les individus, les familles et la propre communauté, les soins à prêter dépassent l’activité développée dans le Centre de Santé. Le projet appliqué qu’on présente concerne un travail de contexte institutionnel et il a pour objet d’étude le Regroupement des Centres de Santé de Cova da Beira – AceS Cova da Beira qui opère dans la prestation des soins de santé primaires. On se procède à la caractérisation et au diagnostic du Service et on présente une solution de gestion de la performance organisationnelle, basée sur l’analyse effectuée et sur la base de l’examen de la littérature composée d’un système de gestion du rendement fondé sur la méthodologie Balanced Scorecard. Les résultats obtenus montrent l’utilisation de Balanced Scorecard comme un Instrument de Gestion Stratégique de la Performance adapté au Service de Santé à l’étude que, dans le cas de mise en oeuvre, proportionnera une effective gestion de la performance organisationnelle, avec une conséquente utilisation efficiente et efficace des ressources, d’une manière stratégiquement équilibrée et alignée.Primary Health Care is the central part of the health system as well as the overall social and economic development of the community. It provides the first contact of the individual, family and community, allowing health care come as close as possible to the places where people live and work. Health care is a fundamental aspect of economic and social development of any country and therefore is of current relevance in our socio-political field. Therefore, we share the main concerns, which tell us that are important to strengthen primary health care and lower the demand for care in the hospital, in order to satisfy better and more economically the requests of inhabitants. And the right to health is a fundamental right of all human beings; the concern of primary health care should focus on the promotion and health education and disease prevention. Thus, in a health service focused on individuals, on families and on the community, the care to be given exceeds the activity carried out within the Health Centre. Health care is a fundamental aspect of economic and social development of any country and therefore take on current relevance in our socio-political domain. The applied project relates to an institutional work and its object of study was the Cova da Beira Health Centers Grouping (ACES Cova da Beira), which operates in the provision of primary health care. The study proceeds to the characterization and diagnosis of Cova da Beira Health Centers Grouping service and presents an organizational performance management solution based on the Balanced Scorecard methodology after the correspondent literature review on performance management system. The results show the use of the Balanced Scorecard as Strategic Management Instrument Performance adapted to the Health Service study that in the case of being implemented, is to provide effective management of organizational performance, with a consequent efficient and effective use of resources in a balanced and strategically aligned manner

Zona de cisalhamento de Juzbado - Penalva do Castelo no sector de Figueira de Castelo Rodrigo: implicações para a exumação de rochas metamórficas de alto grau

A Zona de Cisalhamento Juzbado-Penalva do Castelo (Zona Centro Ibérica) separa unidades com distintas características estruturais, metamórficas e litoestratigráficas, revelando-se como um acidente tectónico de primeira ordem durante a evolução da Cadeia Varisca Ibérica. A realização de cartografia geológica e estrutural detalhada em sectores escolhidos e a sua extrapolação regional, colocou em evidência o carácter progressivo da deformação durante a evolução desta zona de cisalhamento. O novo padrão cartográfico proposto é discutido no contexto da evolução desta zona de cisalhamento em regime transcorrente esquerdo e no quadro do seu papel na exumação do Complexo Anatéctico de Figueira de Castelo Rodrigo-Lumbrales

Auxiliares entomófagos capturados num olival da Terra Quente Transmontana

A valorização da acção dos factores de limitação natural dos inimigos das culturas e um dos princípios essenciais da Protecção Integrada e da Agricultura Biológica. Entre estes factores assume especial interesse a fauna auxiliar indígena, designadamente os parasitóides e predadores das espécies nocivas. Com o objectivo de contribuir para conhecer os principais elementos desta fauna associados a oliveira na Terra Quente Transmontana, realizaram-se amostragens quinzenais entre Julho de 1998 e Fevereiro de 1999, num olival situado em Valbom dos Figos, no concelho de Mirandela. As amostragens foram efectuadas pelo batimento de 50 ramos, através da técnica das pancadas usada em arboricultura. O material obtido foi separado em laboratório, a lupa binocular, tendo-se procedido, em cada data, ao registo do numero de indivíduos das ordens Araneae e Hymenoptera e das famílias Chrysopidae, Anthocoridae. Miridae, Coccinellidae e Formicidae por serem consideradas as de maior interesse na limitação das populações de espécies fitófagas da oliveira. As famílias mais representativas em termos de abundância, foram a Formicidae, com 520 exemplares, seguida da Coccinellidae, com 108 indivíduos. 0 maior numero de capturas, registou-se em Julho e Setembro

The Juzbado-Penalva do Castelo wrench ductile shear zone : a major structure oblique to the main Iberian Variscan trend

The ENE-WSW Juzbado-Penalva do Castelo Shear Zone (JPCSZ), 200 km long and 5-15 km wide, is a first order structure of the Iberian Variscides with a sinistral component emphasized by a 65 km ductile reject of the major D1 structures (Iglesias & Ribeiro, 1981); the NW-SE regional trend (e.g. Marão and Tamames structures) changes to E-W (e.g. Moncorvo and Poiares synclines) when approaching the JPCSZ and even to ENE-WSW along it (e.g. Marofa syncline). Although this sigmoidal pattern clearly post-dated the early structures of the first and main Variscan event (D1), some evidence show that the JPCSZ should have been active since the early Variscan collision (e.g. D1 kinematics changes in both sides of the shear zone), or even earlier (e.g. it is the most plausible boundary between two major pre-Ordovician lithostratigraphic domains - the Beiras and Douro Groups). We present preliminary structural and petrological data for the Figueira de Castelo Rodrigo area (a key region to study the E-W to ENE-WNW transition) in order to constrain its Variscan evolution. In the northern part of the studied area, several syn-tectonic granitoids crop out, whereas to the south migmatites, probably part of the Pre-Cambrian to Cambrian Excomungada Formation (Ribeiro, 2001), predominate. These granulite-facies migmatites (T ≥ 800 ºC) contact, to the south, with Ordovician lowgrade (biotite zone) metapelites and metaquartzites, materializing a “temperature jump” of at least 400 :C, which, considering a barrovian-type geothermal gradient of about 25 :C.km-1, suggests a vertical offset of 16 km (or 8 km for a 50 :C.km-1 geothermal gradient). In the autochthon of the Central Iberian Zone, it is solely along the JPCSZ that high grade metamorphic rocks are exhumed. At the Figueira de Castelo Rodrigo area two segments were identified in the Marofa Syncline. The western segment has a clear ENE-WSW direction trend coincident with the JPCSZ, whereas at the eastern segment, E-W trends predominate. The deformation is much more intense in the western segment, giving rise to a pervasive sub-vertical slightly wavy fold axis associated with a sub-horizontal to slightly northeast dipping stretching lineation; this deformation is coeval with significant recrystallization and the development of a mylonitic foliation. These strong fabrics, better observed in the metapelites and metapsamites interlayered in the Ordovician metaquartzite sequence, show widespread sinistral shear criteria structures (e.g. C-S shear bands, distorted/rotated porphyroclast and consistent asymmetrical folds). This shear sense, also observed in the diatexite lenses inside the JPCSZ, is congruent with the inferred movement from the analysis of the regional structures. The eastern segment is characterized by a less intense deformation, where folds and other related mesoscopic structures are almost absent. Nevertheless, a stretching lineation is often found, ranging from low dip to 50: towards SW. This behavior shows that the eastern segment (E-W trend) has had a predominant thrusting with a sinistral component. The kinematics preserved in this segment was the result of the reworking of previous structures oblique to the main sinistral ENE-WSW shear (JPCSZ), with the consequent induction of a restraining zone along the EW trend

Figueira de Castelo Rodrigo-Lumbrales anatectic complex (Central Iberian Zone): new geothermobarometric data

In the Central Iberian Zone (Iberian Massif) there is a significant change in the Variscan D1 trend from the dominant NW–SE to E–W (Marofa and Ahigal de los Aceiteros synclines). This change is due to the 65 to 100 km sinistral movement of the Juzbado–Penalva do Castelo shear zone (JPCSZ), a composite structure where several shear bands formed as a result of progressive deformation (Pereira et al., 2013). Despite some uncertainties, the JPCSZ has been considered to have been active during the Variscan D3, syn- to-post regional metamorphic peak (Villar et al., 2000). The JPCSZ was responsible for the exhumation of the Figueira de Castelo Rodrigo–Lumbrales anatectic complex, resulting in its juxtaposition to low-grade (350–450 ºC) metasediments. The complex is essentially composed of metatexites, diatexites and twomica anatectic granites. We present new geothermobarometric data in order to better constrain the regional metamorphic climax, as well as the evolution of this first-order Variscan tectonic feature. Mineral analyses were conducted on a JEOL JXA-8200 electron microprobe and P-T estimates were obtained using THERMOCALC software (Holland and Powell, 1998), version 3.33. Due to lack of garnet in the migmatites, peak metamorphism calculations were made using interlayered calc-silicate rocks with a mineral assemblage of plagioclase + biotite + amphibole + clinopyroxene + garnet ± titanite ± apatite ± zircon ± oxides. These minerals are chemically unzoned, displaying flat rim-core-rim chemical profiles. The garnet is grossular-rich (XAlm = 0.51; XPy = 0.05; XGr = 0.31; XSpss = 0.13), whereas clinopyroxene is essentially hedenbergitic (XEn = 0.25; XFs = 0.28; XWo = 0.47). Peak paragenesis is also composed of plagioclase (XAn = 0.95) and ferrohornblende. P-T estimates using garnet-pyroxene-amphibole-plagioclase equilibrium reactions establish the metamorphic peak at 725±50 ºC and 5.4±1 kbar. These new results are compatible with a geothermal gradient of 36 ºC.km-1, slightly higher than that prevailing in typical Barrovian-type conditions, implying relatively shallow depths for crustal anatexis during Variscan orogenic events. These new results provide an explanation for the absence of garnet in the anatectic pelites, whereas the absence of mineral zoning in the peak parageneses suggests fast exhumation of the Figueira de Castelo Rodrigo–Lumbrakes complex induced by the JPCSZ. If the low-grade rocks were formed under the same geothermal gradient, the vertical exhumation of migmatitic rocks from their level of generation to the final juxtaposition with greenschist facies rocks is estimated to be over 12 km

Indicadores antropométricos, aptidão funcional e bem-estar subjetivos dos idosos praticantes de exercício físico

Com o presente estudo pretendeu-se analisar a influência dos indicadores antropométricos e de aptidão física/equilíbrio no bem-estar subjetivo dos idosos, nomeadamente, na vitalidade subjetiva, satisfação com a vida e autoestima global. Tomando em consideração a revisão da literatura e o problema levantado, colocamos a seguinte hipótese: os indicadores de bem-estar subjetivo dos idosos (vitalidade subjetiva, satisfação com a vida e autoestima global) são diferenciados em função dos seus indicadores antropométricos e de aptidão física/equilíbrio.info:eu-repo/semantics/publishedVersio

Exhumation of a migmatite complex along a transpressive shear zone: inferences from the Variscan Juzbado-Penalva do Castelo Shear Zone (Central Iberian Zone)

High-grade metamorphic rocks associated with S-type granites are recorded in the Central Iberian Zone, Iberian Variscides. Though most of these occur as inferred metamorphic core complexes affiliated with detachment faults, others, such as the Figueira de Castelo Rodrigo–Lumbrales Anatectic Complex, crop out between low-grade metamorphic rocks separated by steeply-dipping strike-slip shear zones, such as the Juzbado–Penalva do Castelo Shear Zone. Our structural analysis has been able to constrain two major deformation stages during the Variscan D3: (a) D3a ductile deformation event, with clear sinistral kinematic criteria; and (b) D3b thrusting ductile–brittle deformation event. The petrological investigation confirmed the jump in metamorphic grade between the host rocks and the anatectic complex. P–T estimates on calc-silicate rocks interlayered with the metapelites of the anatectic complex provided minimum metamorphic peak conditions of T = 761 ± 50°C and P = 5.0 ± 1.0 kbar. However, petrological modelling results show that P–T conditions must have exceeded T > 800°C. Both structural and geothermobarometric data support a two-step model for the exhumation of the Anatectic Complex, including a 5 – 8 km vertical exhumation along a 65 – 100 km horizontal displacement due to a simple shear-dominated transpression mechanism during the Variscan D3 events

Can Interpersonal Behavior Influence the Persistence and Adherence to Physical Exercise Practice in Adults? A Systematic Review

Objective: Motivation seems to be a fundamental indicator of long-term physical exercise adherence. Self-Determination Theory (SDT) argues that social environment plays a central role in the satisfaction of basic psychological needs, which might directly affect the quality of one’s motivation. Individuals who appear to be more self-determined tend to persist longer at certain behaviors. Therefore, this body of work intends to analyze the relationship between motivational variables and behavioral outcomes in the exercise context, having as theoretical background the Self-Determination Theory. Methods: This systematic review was conducted through an electronic search on Web of Science, PubMed, SPORTDiscus, and PsycINFO. Data such as instruments, main predictors and results were collected from studies published between 1985 and 2018. A total of 35 empirical studies were considered for a detailed analysis. Results: Results showed the relevance of autonomy support performed by exercise professionals, as well as the major contribution that these behaviors have toward the satisfaction of basic psychological needs, besides the inherent benefits of developing more autonomous regulations. According to the literature, few studies have analyzed interpersonal thwarting behavior and the way this relates to basic psychological needs’ frustration. Nether less, there seems to be a negative relationship between less self-determined regulations and exercise practice. Conclusion: Despite the existence of numerous cross-sectional studies that demonstrate positive correlations between SDT and behavioral outcomes in the exercise context, longitudinal research that analyzes all six dimensions of interpersonal behaviors and their relationship with persistence and adherence to exercise proves to be crucial. However, according to this review, interventions based on SDT appear to be fundamental when it comes to promote the maintenance of a long-term exercise practice.info:eu-repo/semantics/publishedVersio